Healthcare Provider Details

I. General information

NPI: 1447603121
Provider Name (Legal Business Name): MARVIN N PARSONS JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2016
Last Update Date: 12/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

917 TOPAZ DR UNIT G
MAX MEADOWS VA
24360-3804
US

IV. Provider business mailing address

175 W MONROE ST # 141
WYTHEVILLE VA
24382-2341
US

V. Phone/Fax

Practice location:
  • Phone: 276-637-1141
  • Fax:
Mailing address:
  • Phone: 276-637-1141
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: